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The effect of intravitreal bevacizumab injection as the initial treatment for Coats’ disease

  • Retinal Disorders
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Abstract

Background

In Coats’ disease, the most recent development in the treatment has been the intravitreal injection of anti-VEGF agents. The purpose of this article was to evaluate the effect of intravitreal bevacizumab as the initial treatment for Coats’ disease in children and adults.

Methods

The study included 14 pediatric patients and five adult patients with Coats’ disease. They were treated with intravitreal bevacizumab (1.25 mg/0.05 ml) as the initial treatment, combined with or without other treatments. The analyses included the evaluation of basic clinical conditions.

Results

In the pediatric group, after a mean of 9.1 months of follow-up, the differences in visual acuity were significant for the comparisons between the baseline examination and the follow-up examinations carried out at weeks 6, 12, and 24 after the baseline (P = 0.006, P = 0.004, P = 0.005 respectively). Vitreoretinal fibrosis was observed in three patients (n = 3, 21.4 %), among whom two showed fibrosis before treatment. All of the pediatric patients showed a resolution of fluid and exudation, and regression of the telangiectasia. In the adult group, after a mean of 10.6 months of follow-up, the differences in visual acuity were not statistically significant (P > 0.05) between the baseline and follow-up examinations. Vitreoretinal fibrosis (n = 2, 40 %) was observed in two patients who both showed fibrosis before treatment. All of the adult patients showed a resolution of fluid and exudation, and regression of the telangiectasia. The differences in the change of BCVA between children and adults were not significant (P > 0.05) during the follow-up examinations.

Conclusion

The intravitreal injection of bevacizumab as the initial treatment is associated with a measurable gain in visual acuity in patients with Coats’ disease. Resolution of the subretinal fluid and exudation, and regression of the telangiectasia were observed in both pediatric and adult patients. Vitreoretinal fibrosis may be one of the natural courses of Coats’ disease, and it remains uncertain whether bevacizumab accelerates the fibrosis phenomenon.

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Acknowledgements

Publication of this article was supported by Study and Development Fund of People’s Hospital of Peking University(no. RDC2012-21); National Natural Science Foundation of China(no. 81271027).

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Conflict of Interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Ophthalmology, People’s Hospital, & Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University, Beijing, China

    Xiao-Xue Zheng & Yan-Rong Jiang

  2. Department of Ophthalmology, People’s Hospital, Peking University, 11 Xizhimen South Street, Xicheng District, 100044, Beijing, China

    Yan-Rong Jiang

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  1. Xiao-Xue Zheng
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Correspondence to Yan-Rong Jiang.

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Zheng, XX., Jiang, YR. The effect of intravitreal bevacizumab injection as the initial treatment for Coats’ disease. Graefes Arch Clin Exp Ophthalmol 252, 35–42 (2014). https://doi.org/10.1007/s00417-013-2409-1

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  • DOI: https://doi.org/10.1007/s00417-013-2409-1

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